This Is the Unhealthiest City in the US: Ranking America’s Top 50

Published: November 29, 2025 by Christian Drerup

America’s health culture varies widely from city to city, shaped by factors like access to fresh, healthy food, walkability, income levels, healthcare availability, and regional habits. Some urban areas consistently struggle with higher rates of obesity and related health conditions. These are generally due to broader systemic challenges rather than individual behavior. The environments we live in play a major role in our physical well-being, contributing to an assortment of factors like lack of access to nutritious meals and sedentary lifestyles.

This article takes a closer look at the U.S. cities with the highest concentrations of residents labeled as unhealthy or obese. These findings draw attention to how geography, infrastructure, and policy all affect health outcomes. The below rankings highlight the areas of the country where health programs, city planning improvements, and community efforts are most urgently needed.

To determine America’s most inactive metros, 24/7 Tempo reviewed adult physical inactivity rates from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program’s 2023 County Health Rankings and Roadmaps report. The physical inactivity rate is defined as the share of adults 20 years and older who report no leisure-time physical activity. We used the 384 metropolitan statistical areas as delineated by the United States Office of Management and Budget and used by the Census Bureau as our definition of metros. Additional information on the share of adults 20 years and older who report a body mass index of 30 kg/m2 or higher (considered obese), the share of adults reporting poor or fair health, and the life expectancy at birth also came from the 2023 CHR.

50. Elizabethtown-Fort Knox, Kentucky

Adults who don’t exercise: 28.4%
Adult obesity rate: 39.2% — #43 out of 384 metro areas
Adults in poor or fair health: 17.8% — #67 out of 384 metro areas
Life expectancy: 75.8 years — #302 out of 384 metro areas

49. Hattiesburg, Mississippi

Adults who don’t exercise: 28.4%
Adult obesity rate: 39.1% — #44 out of 384 metro areas
Adults in poor or fair health: 18.6% — #47 out of 384 metro areas
Life expectancy: 75.1 years — #339 out of 384 metro areas

48. Victoria, Texas

Adults who don’t exercise: 28.6%
Adult obesity rate: 38.2% — #80 out of 384 metro areas
Adults in poor or fair health: 19.2% — #32 out of 384 metro areas
Life expectancy: 77.5 years — #207 out of 384 metro areas

47. Lexington-Fayette, Kentucky

Adults who don’t exercise: 28.6%
Adult obesity rate: 34.1% — #217 out of 384 metro areas
Adults in poor or fair health: 16.4% — #108 out of 384 metro areas
Life expectancy: 77.4 years — #218 out of 384 metro areas

46. Lafayette, Louisiana

Adults who don’t exercise: 28.6%
Adult obesity rate: 37.0% — #110 out of 384 metro areas
Adults in poor or fair health: 18.1% — #58 out of 384 metro areas
Life expectancy: 76.2 years — #286 out of 384 metro areas

45. Macon-Bibb County, Georgia

Adults who don’t exercise: 28.7%
Adult obesity rate: 38.9% — #58 out of 384 metro areas
Adults in poor or fair health: 19.0% — #39 out of 384 metro areas
Life expectancy: 74.1 years — #368 out of 384 metro areas

44. Lake Havasu City-Kingman, Arizona

Adults who don’t exercise: 28.7%
Adult obesity rate: 35.7% — #160 out of 384 metro areas
Adults in poor or fair health: 16.7% — #99 out of 384 metro areas
Life expectancy: 75.5 years — #319 out of 384 metro areas

43. Merced, California

Adults who don’t exercise: 28.9%
Adult obesity rate: 38.0% — #85 out of 384 metro areas
Adults in poor or fair health: 21.7% — #9 out of 384 metro areas
Life expectancy: 78.2 years — #164 out of 384 metro areas

42. Owensboro, Kentucky

Adults who don’t exercise: 28.9%
Adult obesity rate: 39.1% — #46 out of 384 metro areas
Adults in poor or fair health: 18.2% — #55 out of 384 metro areas
Life expectancy: 76.4 years — #280 out of 384 metro areas

41. Miami-Fort Lauderdale-Pompano Beach, Florida

Adults who don’t exercise: 29.0%
Adult obesity rate: 29.6% — #329 out of 384 metro areas
Adults in poor or fair health: 17.4% — #81 out of 384 metro areas
Life expectancy: 81.5 years — #27 out of 384 metro areas

40. Springfield, Ohio

Adults who don’t exercise: 29.0%
Adult obesity rate: 36.7% — #120 out of 384 metro areas
Adults in poor or fair health: 16.3% — #113 out of 384 metro areas
Life expectancy: 73.9 years — #373 out of 384 metro areas

39. Montgomery, Alabama

Adults who don’t exercise: 29.0%
Adult obesity rate: 44.4% — #2 out of 384 metro areas
Adults in poor or fair health: 19.1% — #34 out of 384 metro areas
Life expectancy: 75.3 years — #328 out of 384 metro areas

38. Visalia, California

Adults who don’t exercise: 29.1%
Adult obesity rate: 36.0% — #147 out of 384 metro areas
Adults in poor or fair health: 22.8% — #7 out of 384 metro areas
Life expectancy: 77.8 years — #194 out of 384 metro areas

37. Hinesville, Georgia

Adults who don’t exercise: 29.1%
Adult obesity rate: 40.7% — #22 out of 384 metro areas
Adults in poor or fair health: 18.3% — #52 out of 384 metro areas
Life expectancy: 76.5 years — #273 out of 384 metro areas

36. Columbus, Georgia-Alabama

Adults who don’t exercise: 29.2%
Adult obesity rate: 38.4% — #72 out of 384 metro areas
Adults in poor or fair health: 18.5% — #48 out of 384 metro areas
Life expectancy: 74.3 years — #361 out of 384 metro areas

35. Muncie, Indiana

Adults who don’t exercise: 29.2%
Adult obesity rate: 40.1% — #29 out of 384 metro areas
Adults in poor or fair health: 17.3% — #82 out of 384 metro areas
Life expectancy: 74.2 years — #366 out of 384 metro areas

34. Gadsden, Alabama

Adults who don’t exercise: 29.3%
Adult obesity rate: 41.1% — #17 out of 384 metro areas
Adults in poor or fair health: 19.1% — #35 out of 384 metro areas
Life expectancy: 72.5 years — #383 out of 384 metro areas

33. Jonesboro, Arkansas

Adults who don’t exercise: 29.3%
Adult obesity rate: 40.5% — #26 out of 384 metro areas
Adults in poor or fair health: 18.7% — #45 out of 384 metro areas
Life expectancy: 75.2 years — #334 out of 384 metro areas

32. Yuma, Arizona

Adults who don’t exercise: 29.4%
Adult obesity rate: 40.5% — #25 out of 384 metro areas
Adults in poor or fair health: 21.1% — #12 out of 384 metro areas
Life expectancy: 80.5 years — #50 out of 384 metro areas

31. Sebring-Avon Park, Florida

Adults who don’t exercise: 29.6%
Adult obesity rate: 39.1% — #51 out of 384 metro areas
Adults in poor or fair health: 19.2% — #30 out of 384 metro areas
Life expectancy: 77.8 years — #193 out of 384 metro areas

30. Enid, Oklahoma

Adults who don’t exercise: 29.6%
Adult obesity rate: 37.9% — #89 out of 384 metro areas
Adults in poor or fair health: 16.4% — #110 out of 384 metro areas
Life expectancy: 75.0 years — #341 out of 384 metro areas

29. Valdosta, Georgia

Adults who don’t exercise: 29.6%
Adult obesity rate: 39.6% — #34 out of 384 metro areas
Adults in poor or fair health: 18.9% — #42 out of 384 metro areas
Life expectancy: 75.3 years — #330 out of 384 metro areas

28. Albany, Georgia

Adults who don’t exercise: 29.6%
Adult obesity rate: 41.4% — #14 out of 384 metro areas
Adults in poor or fair health: 20.0% — #20 out of 384 metro areas
Life expectancy: 73.6 years — #375 out of 384 metro areas

27. Sumter, South Carolina

Adults who don’t exercise: 29.6%
Adult obesity rate: 41.3% — #15 out of 384 metro areas
Adults in poor or fair health: 18.8% — #44 out of 384 metro areas
Life expectancy: 74.3 years — #363 out of 384 metro areas

26. Huntington-Ashland, West Virginia-Kentucky-Ohio

Adults who don’t exercise: 29.7%
Adult obesity rate: 39.1% — #45 out of 384 metro areas
Adults in poor or fair health: 19.4% — #27 out of 384 metro areas
Life expectancy: 73.3 years — #378 out of 384 metro areas

25. Tuscaloosa, Alabama

Adults who don’t exercise: 30.0%
Adult obesity rate: 42.2% — #9 out of 384 metro areas
Adults in poor or fair health: 19.1% — #37 out of 384 metro areas
Life expectancy: 75.4 years — #323 out of 384 metro areas

24. Rome, Georgia

Adults who don’t exercise: 30.1%
Adult obesity rate: 38.1% — #81 out of 384 metro areas
Adults in poor or fair health: 18.3% — #54 out of 384 metro areas
Life expectancy: 74.2 years — #365 out of 384 metro areas

23. El Paso, Texas

Adults who don’t exercise: 30.3%
Adult obesity rate: 37.7% — #92 out of 384 metro areas
Adults in poor or fair health: 22.8% — #5 out of 384 metro areas
Life expectancy: 78.1 years — #171 out of 384 metro areas

22. Beckley, West Virginia

Adults who don’t exercise: 30.5%
Adult obesity rate: 41.8% — #12 out of 384 metro areas
Adults in poor or fair health: 21.7% — #8 out of 384 metro areas
Life expectancy: 71.9 years — #384 out of 384 metro areas

21. Charleston, West Virginia

Adults who don’t exercise: 30.5%
Adult obesity rate: 39.0% — #54 out of 384 metro areas
Adults in poor or fair health: 19.7% — #23 out of 384 metro areas
Life expectancy: 72.6 years — #381 out of 384 metro areas

20. Bowling Green, Kentucky

Adults who don’t exercise: 30.6%
Adult obesity rate: 37.6% — #95 out of 384 metro areas
Adults in poor or fair health: 18.9% — #40 out of 384 metro areas
Life expectancy: 76.2 years — #288 out of 384 metro areas

19. Lake Charles, Louisiana

Adults who don’t exercise: 30.7%
Adult obesity rate: 38.4% — #70 out of 384 metro areas
Adults in poor or fair health: 17.7% — #71 out of 384 metro areas
Life expectancy: 74.5 years — #355 out of 384 metro areas

18. Vineland-Bridgeton, New Jersey

Adults who don’t exercise: 30.8%
Adult obesity rate: 35.7% — #159 out of 384 metro areas
Adults in poor or fair health: 17.8% — #63 out of 384 metro areas
Life expectancy: 74.6 years — #353 out of 384 metro areas

17. Fort Smith, Arkansas-Oklahoma

Adults who don’t exercise: 30.8%
Adult obesity rate: 36.8% — #116 out of 384 metro areas
Adults in poor or fair health: 20.1% — #18 out of 384 metro areas
Life expectancy: 75.4 years — #326 out of 384 metro areas

16. Florence, South Carolina

Adults who don’t exercise: 30.8%
Adult obesity rate: 41.7% — #13 out of 384 metro areas
Adults in poor or fair health: 18.4% — #51 out of 384 metro areas
Life expectancy: 72.6 years — #382 out of 384 metro areas

15. Odessa, Texas

Adults who don’t exercise: 31.1%
Adult obesity rate: 39.6% — #33 out of 384 metro areas
Adults in poor or fair health: 20.4% — #15 out of 384 metro areas
Life expectancy: 73.8 years — #374 out of 384 metro areas

14. Lawton, Oklahoma

Adults who don’t exercise: 31.2%
Adult obesity rate: 39.4% — #36 out of 384 metro areas
Adults in poor or fair health: 18.0% — #60 out of 384 metro areas
Life expectancy: 75.4 years — #324 out of 384 metro areas

13. Shreveport-Bossier City, Louisiana

Adults who don’t exercise: 31.6%
Adult obesity rate: 42.0% — #11 out of 384 metro areas
Adults in poor or fair health: 19.4% — #28 out of 384 metro areas
Life expectancy: 74.9 years — #344 out of 384 metro areas

12. Houma-Thibodaux, Louisiana

Adults who don’t exercise: 31.6%
Adult obesity rate: 40.3% — #27 out of 384 metro areas
Adults in poor or fair health: 19.6% — #25 out of 384 metro areas
Life expectancy: 75.9 years — #297 out of 384 metro areas

11. Dothan, Alabama

Adults who don’t exercise: 31.7%
Adult obesity rate: 39.3% — #42 out of 384 metro areas
Adults in poor or fair health: 20.2% — #16 out of 384 metro areas
Life expectancy: 75.1 years — #338 out of 384 metro areas

10. El Centro, California

Adults who don’t exercise: 31.7%
Adult obesity rate: 36.2% — #138 out of 384 metro areas
Adults in poor or fair health: 24.0% — #4 out of 384 metro areas
Life expectancy: 79.0 years — #115 out of 384 metro areas

9. Dalton, Georgia

Adults who don’t exercise: 32.0%
Adult obesity rate: 39.0% — #53 out of 384 metro areas
Adults in poor or fair health: 19.9% — #22 out of 384 metro areas
Life expectancy: 76.6 years — #264 out of 384 metro areas

8. Corpus Christi, Texas

Adults who don’t exercise: 32.1%
Adult obesity rate: 40.6% — #24 out of 384 metro areas
Adults in poor or fair health: 21.1% — #13 out of 384 metro areas
Life expectancy: 77.1 years — #236 out of 384 metro areas

7. Alexandria, Louisiana

Adults who don’t exercise: 32.3%
Adult obesity rate: 43.2% — #3 out of 384 metro areas
Adults in poor or fair health: 18.6% — #46 out of 384 metro areas
Life expectancy: 73.5 years — #376 out of 384 metro areas

6. Monroe, Louisiana

Adults who don’t exercise: 33.0%
Adult obesity rate: 42.4% — #8 out of 384 metro areas
Adults in poor or fair health: 20.8% — #14 out of 384 metro areas
Life expectancy: 73.3 years — #377 out of 384 metro areas

5. Brownsville-Harlingen, Texas

Adults who don’t exercise: 33.1%
Adult obesity rate: 42.7% — #7 out of 384 metro areas
Adults in poor or fair health: 28.2% — #2 out of 384 metro areas
Life expectancy: 78.8 years — #131 out of 384 metro areas

4. McAllen-Edinburg-Mission, Texas

Adults who don’t exercise: 33.4%
Adult obesity rate: 42.9% — #5 out of 384 metro areas
Adults in poor or fair health: 28.3% — #1 out of 384 metro areas
Life expectancy: 79.5 years — #91 out of 384 metro areas

3. Hammond, Louisiana

Adults who don’t exercise: 33.4%
Adult obesity rate: 40.8% — #19 out of 384 metro areas
Adults in poor or fair health: 19.5% — #26 out of 384 metro areas
Life expectancy: 74.6 years — #352 out of 384 metro areas

2. Pine Bluff, Arkansas

Adults who don’t exercise: 33.7%
Adult obesity rate: 42.9% — #6 out of 384 metro areas
Adults in poor or fair health: 22.8% — #6 out of 384 metro areas
Life expectancy: 72.9 years — #379 out of 384 metro areas

1. Laredo, Texas

Adults who don’t exercise: 38.0%
Adult obesity rate: 44.6% — #1 out of 384 metro areas
Adults in poor or fair health: 27.4% — #3 out of 384 metro areas
Life expectancy: 78.5 years — #143 out of 384 metro areas

(Take a look at the healthiest cities in the U.S.)